Teach and apply stress inoculation and anxiety support

The manuals converge on the idea that anxiety and fear are expected parts of the therapeutic process, and that they can be recognised and supported in the moment rather than treated as failures. Across the extracts, the manuals recommend identifying coping tools, calming or reassuring participants, and responding when anxiety begins to move toward overwhelm or distress. They also share an emphasis on maintaining safety while still allowing meaningful engagement with difficult material. They differ in how explicitly they frame the support. The MDMA-assisted therapy manual focuses on teaching and applying stress inoculation techniques in session, including diaphragmatic breathing, exploring anxiety triggers and how anxiety presents for the participant, and discussing how therapists can recognise and respond to anxiety states. The 5-MeO-DMT manual places more emphasis on coaching through nervousness, fear, and ego-related experiences before, during, and after the session, using trust, words, touch, song, or other techniques, and remaining available for later fear-related processing. The psilocybin training manual is more focused on regulating the therapeutic environment so arousal stays within a tolerable range, with attention to mild-to-moderate transient anxiety as a common acute effect and intervening when distress or paranoia becomes overwhelming.